Fee For Service Universities

Upon requesting a fee schedule from the dean of the college, the latter would patiently explain that different prices had been negotiated with different parents and that all of those fees are proprietary information…

In his defense, the professor would further point out that his university is ringed by law firms eager to sue the faculty on behalf of parents, should their child still confuse Iraq with Iran or should a typographical error be found in their child’s finished and bound senior thesis — a total embarrassment if the neighbors discovered it upon being shown that opus by the proud parents.

If universities conducted their business in this fashion they, too, might provoke endless rancor and suspicion, endless lawsuits and, sooner or later, much government regulation on how they conduct their business. It may be the reason universities prefer to function like staff-model H.M.O.’s.

Case in point, via NYT, which showcases the pernicious role the word experimental has taken on in the health-insurance industry lexicon:

Maria Carr had a bone-spur on her hip and seeks arthroscopic surgery to stop the pain

UHC denies the claim, and the hospital bills $21,225

Carr researches the procedure, establishes that it’s not experimental, collects an attestation from her doctor, and fights the denial. Presumably, having failed to win approval from the internal board, it is sent an external review board: the procedure is not experimental if UHC or other Insurers paid for other patients to have it

UHC pays $12,282 for Carr’s claim, a rate that UHC had negotiated with the doctor and hospital, and Carr contributes $500

Carr conducted the process herself, but a cottage industry of billing advocateshas sprung up around